Health
Bill Gates Explains His Plans to Close the Gates Foundation in 2045
Donald Trump is the face of these cuts, but the cruelty of his administration is not the only story. After leaping upward in the 2000s, global giving for health grew very slowly through the 2010s. The culture of philanthropy has changed somewhat, too, with the age of the Giving Pledge — in which hundreds of the world’s richest people promised to donate more than half of their great fortunes to charity — yielding first to the upstart movement called Effective Altruism and then to a new age of extreme wealth defined less by altruism than by grandiosity. After the Gateses’ divorce in 2021, Melinda eventually left the foundation to establish her own philanthropy; Warren Buffett, a longtime supporter, recently announced his plans to leave most of his remaining fortune in the hands of a charitable trust his own children will administer, and to give no additional money to the Gates Foundation beyond his death. After a few years of slow post-Covid decline, this has been the year that foreign aid — as the Gates Foundation’s chief executive, Mark Suzman, wrote recently in The Economist — “fell off a cliff.”
On the ground, progress has been bumpy, too, particularly in the aftermath of the pandemic emergency, when many routine vaccination programs were paused and the world’s poorest countries were thrown, en masse, into extreme debt distress. The share of the world’s population living in extreme poverty fell by almost three-quarters between 1990 and 2014, but it has hardly shrunk since.
To hear Gates and his team tell it, this is the time to go all in — given the yawning gaps produced by post-pandemic setbacks and the Trump assault, and given the promise of biomedical tools and other lifesaving innovations now in the development pipeline, and given A.I., a subject Gates returns to again and again. They even talk excitedly about a world in which the Gates Foundation has made itself unnecessary. That world sounds tremendously appealing. But — given the obstacles — can it be built?
Over two days in late April, I spoke with Gates about the state and legacy of his philanthropic endeavor, its achievements and disappointments thus far and what lies ahead. What follows is an edited and condensed version of those conversations, in which he was sunny, detailed and confident, sometimes to the point of brusque certainty, that the next few decades would yield even more radical improvements in global development than what he called, in retrospect, “our miraculous period.”
I. ‘Millions of Additional Deaths of Kids’
Let’s talk about the very present tense, with the Trump administration completely turning its back on foreign aid and leaving not just many millions of people but also most of the world’s global institutions in the lurch. How bad is it?
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As the popularity of GLP-1 drugs continues to climb, significant weight loss associated with the medications has been linked to a growing list of cosmetic concerns.
Some surgeons report that more patients are seeking treatments for so-called “Ozempic earlobes,” which reportedly appear thinner, longer or more sagging after the loss of facial fat.
“The use of semaglutides causes you to lose fat across your body, including the small, fat pads of the earlobes,” facial plastic surgeon Sachin S. Parikh, MD, told NewBeauty.
OZEMPIC, OTHER SEMAGLUTIDES LINKED TO HAIR LOSS: HERE’S WHAT TO KNOW
“It’s important to note that semaglutides do not damage ear tissue or affect hearing in any way, so any intervention would be purely cosmetic,” added the California-based doctor.
Some of the potential treatments for “Ozempic earlobes” may include dermal filler, fat transfer, laser treatments or surgical earlobe reduction, according to the report.
As the popularity of GLP-1 drugs continues to climb, significant weight loss associated with the medications has been linked to a growing list of cosmetic concerns. (iStock)
Dr. Mohammed Asif from Duly Health and Care in Naperville, Illinois, said that while he hasn’t personally noticed an uptick in ear surgeries, he has seen a rise in other procedures due to GLP-1-triggered weight loss.
Some of those include panniculectomies (Ozempic skin removal surgery) and abdominoplasties (tummy tucks).
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“There has been a significant increase in body contouring procedures among patients with GLP-1 weight loss,” Asif told Fox News Digital.
“In my practice, I’ve seen a significant surge in breast lifts, panniculectomies (skin removal surgery), abdominoplasties (tummy tucks), brachioplasties (arm lifts) and thighplasties due to weight loss.”
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Healing and recovery are “far greater and less complicated” than with bariatric surgery weight loss, Asif noted.
“This is due to the gradual weight loss achieved over time with GLP-1s.”
“Ozempic breast” is another common complaint, according to Dr. Michael Omidi, a double board-certified plastic surgeon practicing in Beverly Hills.
“There has been a significant increase in body contouring procedures among patients with GLP-1 weight loss,” a doctor told Fox News Digital. (iStock)
“Women in their 30s and 40s would not typically need a breast lift, but when you’re taking drugs like Ozempic or Wegovy that cause rapid weight loss, women can see gravity take its toll on their breasts,” he told Fox News Digital.
“When women, especially younger ones, lose fat too fast, it causes the breasts, which are comprised of fat, glandular tissue and skin, to lose volume,” he went on. “The skin and supporting ligaments don’t always bouce back at the same rate as the weight loss, resulting in breasts that can appear saggy and deflated.”
NEW OBESITY TREATMENT MAY HELP PRESERVE MUSCLE DURING WEIGHT LOSS
Dr. Samuel Golpanian, a double board-certified plastic surgeon in Beverly Hills, said he has seen “dozens” of patients – men and women alike – seeking treatments for so-called “Ozempic butt” after significant weight loss.
“This is an unintended consequence of taking GLP-1s,” he told Fox News Digital.
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“Such dramatic weight loss in a short period of time causes the skin not to tighten quickly enough to keep up with the body’s changes. Our buttocks have a large amount of fat, so when that volume disappears quickly, you’ll develop a flatter, saggier behind.”
“Such dramatic weight loss in a short period of time causes the skin not to tighten quickly enough to keep up with the body’s changes,” a surgeon said. (iStock)
Kristy Hamilton, MD, a Houston-based surgeon who is a member of the American Society of Plastic Surgeons (ASPS), agreed that a growing number of patients are seeking skin-tightening procedures after losing large amounts of weight with GLP-1s.
“We’re absolutely seeing more of those patients, and I expect that trend to continue,” said Hamilton in an ASPS report.
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“People are losing as much as 100 pounds on this medication – and when you’re losing that amount, that’s significant. You’re certainly going to have excess skin afterward.”
The ASPS lists the following body-contouring procedures as the ones most frequently performed after substantial weight loss.
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- Tummy tuck (abdominoplasty): Removes excess abdominal skin and fat
- Lower body lift (belt lipectomy): Addresses the abdomen, buttocks, hips and thighs
- Arm lift (brachioplasty): Removes hanging upper-arm skin
- Thigh lift: Tightens excess skin of the inner thighs
- Breast lift (mastopexy): Addresses sagging, deflated breasts after weight loss
- Facelift/neck lift: Addresses facial volume loss and skin laxity after major weight loss
“People are losing as much as 100 pounds on this medication – and when you’re losing that amount, that’s significant. You’re certainly going to have excess skin afterward.” (iStock)
Experts say adequate protein intake and resistance training can help minimize the loss of lean muscle mass that often accompanies rapid weight loss, which could reduce some of the cosmetic concerns.
Golpanian also emphasized the importance of eating enough protein.
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“It can be harder since your appetite is suppressed, but it’s so important to consume at least 110 grams of protein a day while taking a GLP-1 drug,” he advised.
“Also, I say this to my patients all the time: You have to lift weights to keep your muscles from atrophying. Strength training can help build muscles and preserve your glutes.”
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No sex for the win? This was the advice given to this year’s NBA champions.
New York Knicks owner James Dolan addressed the now-champs as they headed into the playoffs in April 2026, acknowledging their high potential to eventually win the championship.
“I don’t know if you understand what it would mean for you to win a championship this year … It would be life-changing,” he said. “It will stick with you the rest of your lives, and if you don’t win, you’ll be thinking about it the rest of your lives.”
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As Dolan’s inspirational speech to the team went on, he explained how the next 10 weeks would require each player to make sacrifices – watching their diets, getting proper sleep and perhaps even abstaining from sex.
“You need sacrifice and you need to eliminate all the distractions around you,” he said.
Jalen Brunson of the New York Knicks celebrates with the Bill Russell NBA Finals Most Valuable Player Award trophy and Knicks owner James Dolan after defeating the San Antonio Spurs in Game Five of the 2026 NBA Finals at Frost Bank Center in San Antonio, Texas, on June 13, 2026. (Gregory Shamus/Getty Images)
“I had this idea that maybe you should give up sex for the next 10 weeks,” the owner said. “You don’t have to give up sex for the next 10 weeks – but, like the Spartans … They denied themselves, so that they can have an edge. Get the edge.”
This received a few snickers from the team, and Dolan responded, “Don’t tell [your wives and girlfriends] you’re not going to have sex and don’t tell them it was my idea. But let them know what this is going to be like … and how they’re going to have to sacrifice, too.”
DOCTORS WARN SOME POPULAR FOODS AND DRINKS COULD BE SECRETLY SABOTAGING MEN’S TESTOSTERONE LEVELS
Dr. Anna Elton, licensed marriage and family therapist and clinical sexologist in Massachusetts, confirmed that this belief has been around for centuries, dating back to the ancients Spartans and early Olympic competitors.
Avoiding sex can preserve energy, increase aggression and sharpen focus, according to Elton.
The theory behind abstaining from sex for better athletic performance supports that it can preserve energy, increase aggression and sharpen focus. (iStock)
But modern research has found little evidence that consensual sexual activity negatively impacts strength, endurance, reaction time or athletic performance when it occurs at least 10 hours before competition, the doctor countered.
However, “activity very close to competition may affect recovery measures,” she added. What may be more important, according to Elton, is the psychological value of abstinence.
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“Choosing to abstain can reinforce discipline and total commitment to a larger goal,” she said. “In those cases, the advantage may come more from mindset and focus than from any physical effect.”
“Whether the sacrifice is alcohol, social activities, favorite foods or sex, the message is often the same: ‘We are all in.’”
New York Knicks guard Jalen Brunson celebrates with teammates after the Knicks defeated the San Antonio Spurs in game five of the 2026 NBA Finals at Frost Bank Center in San Antonio, Texas, on June 13, 2026. (Geoff Burke/Imagn Images)
The science of abstinence
This discussion has historically focused on men, which Elton said is often based on “misconceptions about testosterone and energy depletion.”
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“Research has not demonstrated that normal sexual activity causes a meaningful decline in athletic performance, and concerns about testosterone depletion have not been consistently supported by the evidence,” she said.
“For women, sexual activity may have additional benefits related to stress reduction, emotional regulation and relationship satisfaction.”
Abstaining from sex for athletic performance may create a sense of discipline, minimize distractions, maintain focus on training and reinforce a team culture centered on sacrifice and commitment, experts say. (iStock)
In a separate interview with Fox News Digital, Dr. Anthony Puopolo, a men’s health expert and lead medical provider for RexMD, echoed Elton’s assessment that research largely does not support abstinence as a performance enhancer.
This is despite a small amount of evidence that suggests engaging in sexual activity within two hours of competition could pose a risk to cardiovascular recovery.
WEIGHT LOSS MEDICATIONS COULD IMPACT SEXUAL HEALTH IN UNEXPECTED WAYS
“Unfortunately, nearly all studies (99%) have been conducted in males aged 20 to 40, so there is virtually no data on female athletes, older athletes or diverse populations,” said the Puerto Rico-based expert. “We know what to tell the Knicks, but we are not sure what to recommend for the New York Liberty.”
Importance of connection
Elton said abstinence may still offer psychological benefits for some competitors. “For some athletes, it can become part of a pre-competition ritual that enhances confidence,” she told Fox News Digital.
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Some other potential benefits of sexual activity include stress reduction, improved sleep, mood enhancement, emotional connection with a partner and relief from performance-related tension.
“Strong, supportive relationships are associated with better psychological resilience, which can be valuable during high-pressure competitions,” Elton said.
“One of the most overlooked performance advantages may be having a supportive relationship waiting at home,” a doctor said. (iStock)
“Ultimately, there is no universal rule,” she went on. “What helps one athlete perform at their best may not help another.”
Elton stressed that sleep, recovery, nutrition, stress management and support from loved ones are universal performance boosters.
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“Athletes devote tremendous attention to training their bodies, while overlooking the importance of their personal relationships,” she cautioned. “A supportive partner can be one of the greatest assets during a demanding season.”
“If competition requires temporary sacrifices, make those decisions together and keep communication open.”
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